Used Needle Exposes Patient to AIDS : Disease: A syringe used on an AIDS patient is reused on a woman being treated at Mercy Hospital for a minor back injury. Federal and state agencies are investigating, and a lawsuit is pending.

A 23-year-old San Diego woman was exposed to a deadly virus at a hospital here after having been treated with a syringe used previously on a patient with AIDS, medical officials said Wednesday.

The woman, whose name was not released, was notified by doctors at Mercy Hospital 36 hours after being treated for job-related back pain that she had been exposed to the human immunodeficiency virus (HIV), which causes AIDS, her attorney said.

Representatives of the federal Centers for Disease Control in Atlanta and the State Department of Health Services confirmed Wednesday that the incident, which happened Sept. 25, is under investigation.

Harvey Levine, the attorney representing the woman and her family, said Wednesday he intends to file suit in February against Mercy Hospital and its parent corporation, Catholic Health Care West.

Levine said a 90-day waiting period accompanies any case in which doctors or hospitals are named as defendants. He said officials at Mercy, which is in the Hillcrest section of San Diego, have refused to provide records pertaining to the case.

Levine said this is the first case in the United States in which a patient has been exposed to an AIDS-related virus through injection with a syringe used previously on another person--a claim federal and state officials could not confirm.

Dick Keyser, the president of Mercy Hospital, acknowledged Wednesday that a critical mistake was made.

Asked why the syringe was not disposed of, he said, “Obviously, that should have happened.”

“The medical risk to this patient is very limited,” Keyser said, because the needle was inserted into a tube, which was attached to the woman’s body, rather than being injected directly through the skin.

Levine said his client may know within three months whether she’s HIV-positive, but she faces “an umbrella of danger” for the rest of her life.

“She faces issues of future employability, problems in her relationships with men and in whether she’s eligible for certain types of health insurance,” Levine said. “This is a nightmare of major proportions.”

Levine said the woman, whose occupation he refused to disclose, was sent to the hospital with an “insignificant lower-back injury” she sustained at work. She received a magnetic resonance imaging test--a type of X-ray--which turned up negative.

“There was no problem with her disc or cervical spine,” Levine said. “It was very minor. For some reason, the worker’s compensation doctor decided to order a bone scan. That involved a radioisotope-dye injection, which would have detected a herniated disc. Even without the risk of AIDS, they should have realized that radioisotope dye, once it’s used, is nothing less than nuclear waste.

“She received the injection, and 36 hours later, on Sept. 27, she received a call at 1:15 a.m. She was told to report to the hospital immediately, that she ‘might have caught a virus.’ She reports to the hospital and is greeted by the head of the radiology department, a hospital vice president and a physician who specializes in infectious diseases.

“She was then told she had been injected with a syringe used previously on a patient known to be HIV-positive, and that the same syringe, instead of being disposed of by the attending technician, was then used on her. They refused to explain how or why such a mistake occurred.”

Levine and physicians unrelated to the case say it is customary for “any and all” syringes to be disposed of as soon as they’re used.

“The standard procedure is that you never use a used syringe on another person,” said Dr. Donald Ramras, deputy director of the San Diego County Health Services Department. “You use a syringe only once. Obviously, someone made a big mistake.”

Keyser refused to name the technician who made the injection but did say the person was no longer employed by the hospital. He refused to say whether the technician had been fired.

Ernie Trujillo, district manager for the division of licensing and certification for the State Department of Health Services, confirmed Wednesday that his agency is investigating the hospital.

Trujillo said Mercy Hospital reported the incident to his agency in early October, about a week after it happened. He said the worst that could happen to Mercy would be a review that might cause the hospital’s certification to be re-evaluated on a state and federal level.

Dr. George Rutherford, the chief of the infectious diseases branch of the State Department of Health Services, said Wednesday that he’s more concerned “about the larger issues this case raises.”

“Are there blind spots involving infection control that we’re overlooking?” Rutherford said from his office in Berkeley. “Procedures are quite a bit different now than they were five years ago, before AIDS became so prominent.

“With the advent of AIDS, infection control guidelines have been extensively revamped. But our concern is whether they’re adequate enough even now to address all possible situations. The harsh reality in a hospital setting is, we need to treat everyone as if they have a highly infectious disease.”

Rutherford said that, in developing countries, needles are re-used “constantly, but in the United States? No, it’s a big no-no, even before the AIDS scare.”

Attorney Levine accused the hospital of trying to cover up the mistake, but Keyser said the “error was not detected until about 24 hours after it was made.”

“I don’t wish to comment on that,” Keyser said. “Our No. 1 concern right now is that patient. We contacted her and got the infectious-disease specialist involved in it immediately. We’re very concerned. Any time something isn’t in the best interest of a patient, it’s a big concern to everybody around here. We’re doing everything we can to see that an incident like this never happens again.”

Levine said he also wondered whether other patients at Mercy might have been exposed--which Keyser heatedly denied. Levine said his client is now suffering side effects from injections of AZT, an anti-viral drug used to slow the march of the AIDS virus through the body’s system.

“The people at Mercy traumatized her,” Levine said. “They forced a terrible decision on her with AZT, saying she might incur risks of cancer, as well as liver and kidney damage, but ‘It’s up to you.’ ”